Aim: To compare the effectiveness of self-examination, clinical examination and screening methods using 1% toluidine blue and Lugol's iodine in estimating the prevalence of lesions at risk of malignancy and oral malignant disease amongst the male inmates of Yerwada Central Jail, Pune. Material and Methods: Study was carried out on male inmates in two phases. In the first phase self-examination and clinical examination was carried out on 2,257 male inmates. 164 suspicious cases were subjected to phase II of the study out of whom, 82 participants were screened with 1% toluidine blue and 2% Lugol's iodine followed by biopsy procedure. Results: Sensitivity and specificity for self-examination with clinical examination was 92.2% and 96.6% respectively. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) and positive (+LR) and negative likelihood ratio (-LR) for Toluidine Blue were 88.1%, 66.6% 97.1%, 30%, 2.63 and 0.17 respectively while for Lugol's Iodine they were 94.7%, 83.8%, 98.6%, 55.5%, 5.67 and 0.06 respectively. Conclusions: Prevalence of lesions at risk of malignancy and oral malignant disease by self-examination was 7.8% and by clinical examination was 6.3%. Self-examination is an effective tool in early detection of oral cancer. Use of Lugol's iodine as a screening tool for oral lesions is highly effective in inmate populations.

Overall observations indicated the need to comply with standard guidelines of reporting research.

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Introduction:The proposed new index by Dr. Frencken: Caries Assessment Spectrum and Treatment (CAST) Index. It addresses the assessment of clinical stages of carious lesion progression in enamel, dentine, pulp and cavity restored under 9 codes. Content validity as a part of psychometric testing was conducted by Frencken in Brazil, which included 15 countries and India was not included. Hence, the aim of this study was to assess the face and content validity of CAST Index in India. Materials and Methods: Face and content validity of CAST Index was conducted amongst dentists with post-graduate degree qualification (Conservative and Endodontics, Pediatric Dentistry, Public Health Dentistry and Oral Medicine and Radiology) in India. The proforma for content and face validation containing the description of the index along with the original article was given in person to 20 Subject Matter Experts (SME's) through convenience sampling. Results: The SME's concluded that face validity of CAST Index seemed to be a reasonable way of recording dental caries, and it was feasible and appropriate with certain modifications to use in the Indian population. The content validity ratio of all the codes of CAST Index showed that the "ACCEPTABLE" codes were 0, 2, 3, 5, 6, 7 and 8. Conclusion:The CAST Index could be used for epidemiological surveys in India but with a few modifications of the original index. Furthermore, its application can be justified due to a varied population with different socio-economic and cultural backgrounds in India and it also covers the entire spectrum of dental caries.

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Caries lesion progression is highly dynamic process characterized by alternating periods of dissolution and redeposition of minerals in the dental hard tissue. When outcome of these processes overtime is a net loss of mineral, a caries lesion develops or progresses. However, when redeposition of mineral predominates, the result may be arrest of lesion progression or remineralization. Clinical observations suggest that caries lesion can be arrested at any stage of lesion development provided that clinically plaque-free conditions are maintained. Hence, the profession must become aware of the importance of identifying the early evidence of disease. The effective dentistry requires early identification of disease, early identification of individual at high risk of developing caries so that they may receive early preventive intervention. The profession needs understand pattern of disease distribution and its determinants and should put efforts for its early caries detection and preventive management strategies.

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